Lect 3 Nutrition Flashcards
What are the 3 Purposes of Nutrition
Supply energy to perform work
Provide building blocks for biosynthesis
Support functioning of metabolic pathways
What is the breakdown of sources of energy ( _ % of kcal) ?
CHO: 60% of kcal
Lipids: 30% of kcal
Protein: 10% of kcal
Energy Conversion of Each Nutrient to kcal/g
CHO: 4 kcal/g
Proteins: 4 kcal/g
Lipids: 9 kcal/g
Alcohol: 7 kcal/g
What Factors Influence BMR
Age
Gender
Health
Hormones
Calculating Total Energy Expenditure (TEE)
TEE = BMR x physical activity level (PAL)
Thermic effect of food and Non-Exercise Induced Thermogenesis also components
BMI Calculation
BMI = weight (kg) / height2 (m2)
BMI < 18.5
Underweight
BMI 35.0 - 39.9
Obese Stage 2
BMI 18.5 -24.9
Normal/Healthy
BMI >40.0
Morbidly Obese
BMI 25.0 - 29.9
Overweight
BMI 30.0-34.9
Obese Stage I
Site for Digestion & Absorption
- Small Intestine
- Duodenum
- Jejunum
- Ileum: Bile acids, Vit B12
What is Crohn Disease and what does it cause?
Treatment options?
- Autoimmune disease causing chronic inflammation/damage of bowel mucosa (distal ileum)
- Nutritional deficiencies caused by malabsorption
- Vit B12, Fat Soluble Vitamins (ADEK), Fats
- Tx: Surgical resection of diseased segments
What are 6 common Electrolytes/Dietary Minerals and their sources?
K (unprocessed foods)
Na (Dietary salt)
Cl (Dietary salt)
Ca (Milk/Dairy)
PO4 (Dairy)
Mg (Meat, Fish, Veg, Nuts)
Vitamin B1 name?
Coenzyme form?
Deficiency caused by?
Clinical manifestations?
- Thiamine
- Coenzyme: Thiamine Pyrophosphate (TPP)
- Deficiency: Alcoholism
- Wernicke’s –> Ataxia, nystagmus
- Korsakoff’s –> Psychosis
- Dry Beriberi –> Muscle wasting, partial paralysis
- Wet Beriberi –> Cardiac failure, peripheral edema
Vitamin B2 name?
Coenzyme form?
Deficiency from?
Clinical manifestations?
- Riboflavin
- Coenzyme: FAD/FMN
- Deficiency: Poor dietary intake or malabsorption syndromes
- Clinical: Corneal neovascularization, magenta colored tongue, cheilosis, stomatitis
Vitamin B3 name?
Coenzyme form?
Deficiency from?
Clinical Manifestations?
- Niacin
- Coenzyme: NAD(H) and NADP(H)
- Deficiency:
- Hartnup Disease: Impaired AA absorption from intestines and reabsorption in kidneys –> Tryptophan deficiency –> Niacin deficiency
- Malnutrition –> Diets high in untreated corn
- Pellagra (Diarrhea, Dementia, Dermatitis, Death)
Vitamin B5 name?
What coenzyme is it a part of?
What is it required for?
Deficiency from?
Clinical manifestations?
- Pantothenic Acid
- Synthesis of CoA
- Required for acylation and acetylation
- Signal transduction and enzyme activation/deactivation
- Deficiency: extreme starvation
- Dermatitis, numbness, paresthesia, muscle cramps, enteritis, alopecia, hypoglycemia
Vitamin B6 name?
What is it converted to in the body?
Deficiency from?
Clinical manifestations?
- Pyridoxine
- Converted to pyridoxal phosphate in body
- Aminotransferase reactions (ALT & AST)
- Deficiency: Isoniazid Therapy
- Clinical: Sideroblastic anemia (can’t incorporate iron into heme)
Vitamin B7 name?
What is it a cofactor for?
Deficiency from?
Clinical manifestations
- Biotin
- Cofactor for Carboxylation Enzymes
- Gluconeogenesis (Pyruvate carboxylase)
- FA Synthesis (Acetyl CoA carboxylase)
- Deficiency: excessive raw egg consumption
- Clinical: Alopecia, rashes, bowel inflammation, muscle pain
Vitamin B9 name
Coenzyme for what type of reactions?
Deficiency from?
Clinical manifestations?
- Folic Acid
- Tetrahydrofolate (THF) coenzyme for 1C transfer/methylation reactions
- Deficiency:
- Folate pool depleted in alcholics and pregnancy
- Pregnancy –> Neural Tube Defect (spina bifida)
- Side effect of drugs –> Methotrexate
- Folate pool depleted in alcholics and pregnancy
- Clinical: Macrocytic megaloblastic anemia, Homocysteinemia
Vitamin B12 name
What is it converted to?
Deficiency from?
Clinical manifestations?
- Cobalamin
- Converted to coenzymes methyl- or deoxyadenosyl cobalamin
- Deficiency:
- Pernicious anemia (most common)
- Clinical: Megaloblastic anemia, neuropathies, homocysteinemia
Vitamin C name?
Cofactor for?
Deficiency from?
Clinical Manifestations
- Ascorbate
- Cofactor: Collagen and carnitine synthesis, Dopamine –> Norepi, Antioxidants
- Deficiency: Dietary, no citrus fruits or green vegetables
- Clinical: Scurvy with Petechiae (purple hemorrhagic spots under skin), ecchymoses, spongy/bleeding gums, and poor wound healing
Vitamin A main functions and associated structures?
Deficiency from?
Clinical Manifestations?
When is it toxic?
- Vision
- Retinal
- Maintenance of Epithelium
- Retinol & Retinoic Acid –> Normal differentiation of epithelial cells into specialized tissues
- Deficiency: Extreme malnutrition, Fat malabsorption, Liver cirrhosis (most common in US)
- Clinical: Night blindness, visual impairment, xerophthalmia (dry eye syndrome), growth impediment, dry skin, alopecia.
- Toxicity: Teratogenic in pregnancy
- Birth defects such as cleft palates and heart abnormalities
Vitamin D forms?
Functions in different systems?
Deficiencies?
- Forms
- Ergocalciferol (D2)
- Cholecalciferol (D3): sun exposure
- Calcifediol (25-hydroxy Vit D): storage form in liver
- Calcitriol (1, 25-hydroxy Vit D): active vit D, formed in kidneys in response to PTH (increase Ca and PO4)
- Functions
- GI Tract: induce syn of Ca binding proteins, increase PO4
- Kidney: stim reabsorption of Ca and PO4 secretion
- Bone: act on osteoblast receptor –> osteoclast activation –> bone resorption
- Deficiencies:
- Inadequate dietary intake, malabsorption of lipids, poor liver/kidney functioning, hypoparathyroidism, lack of sun exposure
- Childhood Rickets (Skeletal abnormalities)
- Adult osteomalacia (fewer deformities)
